【摘要】 目的 比较喉罩全麻与气管插管全麻两种麻醉方法在小儿侧卧位短小手术中的优缺点。 方法 2009年6月-2010年2月，将40例择期行侧卧位短小手术儿患，随机分为喉罩全麻（L）组与气管插管全麻（T）组，每组各20例。观察患儿术中心率（HR）、平均动脉压（MAP）、脉搏血氧饱和度（SpO2）、气道峰压（Pmax），恶心呕吐、术后躁动等围术期不良反应。 结果 T组插管后及拔管后即刻HR、MAP均高于L组患儿（P lt;0.05）；SpO2、Pmax在两组之间比较差异无统计学意义（P gt;0.05），T组患儿术后躁动发生率明显高于L组（P lt;0.05）。 结论 喉罩可以安全、有效地用于小儿侧卧位短小手术麻醉，且操作简便，插管期和拔管期心血管应激反应轻，术后躁动发生率低。
【Abstract】 Objective To compare the safety and efficacy of laryngeal mask airway (LMA) and tracheal tube in lateral general anesthetic operation on children. Methods From June 2009 to February 2010, 40 children scheduled to undergo general anesthesia for minor surgical procedures in lateral position were randomly divided into the laryngeal mask airway group (group L) and the tracheal tube group (group T) with 20 in each. Heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO2), top airway pressure (Pmax) of the patients were observed. In addition, side effects such as nausea, vomiting, and emergence agitation were also recorded. Results HR and MAP of patients in group T were significantly higher than those of patients in group L after intubation and after extubation (P lt;0.05). There was no difference in Pmax and SpO2 between the two groups (P gt;0.05). The incidence of emergence agitation in group T was significantly higher than that in group L. Conclusions LMA intubation can provide the same safe and effective ventilation as tracheal intubation for children undergoing lateral general anesthetic operation. LMA is superior to tracheal intubation in insertion response, and the incidence of emergence agitation is lower.
Citation：
LI Xiuze,LI Wei,XIA Qing. Application of Laryngeal Mask Airway General Anesthesia in Lateral Operation on Children. West China Medical Journal, 2011, 26(3): 421-423. doi:
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- 1. 李卫, 李秀泽, 畅文丽, 等. 喉罩-雷米芬太尼复合七氟醚或丙泊酚麻醉在烧伤整形术中的应用[J]. 临床麻醉学杂志, 2008, 24(6): 437-439.
- 2. 张秦, 郑宏. 利多卡因与芬太尼用于预防丙泊酚注射痛的比较性研究[J]. 新疆医科大学学报, 2008, 31(6): 714-716.
- 3. 庄心良. 现代麻醉学[M]. 3版. 北京: 人民卫生出版社, 2006: 1421-1424.
- 4. 郑颖, 连文洁, 王春英, 等. 喉罩与气管插管用于全麻乳腺癌根治术的比较[J]. 临床麻醉学杂志, 2007, 23(4): 288-290.
- 5. Bordes M, Semjen F, Degryse C, et al. Pressure-controlled ventilation is superior to volume-controlled ventilation with a laryngeal mask airway in children[J]. Acta Anaesthesiol Scand, 2007, 51(1): 82-85.
- 6. Wittmann PH, Wittmann FW. Laryngeal mask and gastric dilation[J]. Anesthesia, 1991, 46(11): 1083.
- 7. Nunez J, Hughes J, Wareham K, et al. Timing of removal of the laryngeal mask airway[J]. Anaesthesia, 1998, 53(2): 126-130.
- 8. Kitching AJ, Walpole AR, Blogg CE. Removal of the laryngeal mask airway in children: anaesthesized compared with awake[J]. Br J Anaesth, 1996, 76(6): 874-876.
- 9. 孙瑛, 许文音, 胡洁. 曲马多复合小剂量丙泊酚对小儿七氟醚麻醉术后躁动的影响[J]. 上海交通大学学报(医学版), 2010, 30(1): 73-75.
- 10. 汪忠玉, 魏薇, 郑利民. 小剂量氯胺酮用于瑞芬太尼麻醉后痛觉过敏的临床研究[J]. 中国实用医药, 2009, 4(4): 19-20.
- 11. Meyer RR, Munster P, Werner C, et al. Isoflurane is associated with a similar incidence of emergence agitation/delirium as sevoflurane in young children: a randomized controlled study[J]. Paediatr Anaesth, 2007, 17(1): 56-70.
